全麻诱导用药对气管狭窄患者插管的影响  

The Effect of general anesthesia with Medicine of Induction on Tracheal Stenosis Patients

作　　者：邵雪泉[1] 占霖森[1] 王之成[1] 余功敏[1] 潘中心[1] 郑丽花[1] 黄莉[1] 

机构地区：[1]浙江省衢州市人民医院麻醉科,衢州324000

出　　处：《中国中西医结合外科杂志》2012年第5期462-465,共4页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：浙江省医药卫生科研基金项目(2010KYB140);衢州市科技计划项目(20111063)

摘　　要：目的:比较右美托咪啶-七氟烷、七氟烷复合瑞芬太尼麻醉诱导用于气管狭窄患者插管的效果。方法:气管狭窄需插管全麻的颈胸部手术患者40例,采用随机数字表法分为两组,DS组先静脉恒速泵输注右美托咪啶1μg/kg,然后面罩吸入8%七氟烷;SR组面罩吸入七氟烷,睫毛反射消失时45s内缓慢静脉注射瑞芬太尼2μg/kg。采用Viby-Mogensen评分法评价气管插管条件。结果:与SR组相比,DS组咳嗽反射、肢体反应的满意率和气管插管首次成功率均升高;气管插管期间SR组有4例发生低血压、2例心动过缓,DS组无1例需提升血压和心率。结论:与瑞芬太尼比较,应用推荐剂量的右美托咪啶1μg/kg复合七氟烷麻醉诱导,能提供更好的插管条件,不良反应少,且可在维持自主呼吸下行气管插管。Objective Compared the effect of Dexmedetomidine-Sevoflurane and Sevoflurane-Remifentanil induction on the tracheal intubation for patients with tracheal stenosis. Method Forty patients, with tracheal stenosis and cervical or thoracic operation were randomly divided into two groups（n=20 each）： Dexmedetomi- dine-evoflurane groups （DS） and Sevoflurane Remifentanil group（SR）. Patients in Dexmedetomidine Sevoflurane groups （DS） were injected intravenously Dexmedetomidine by TCI ,1 μg/kg, then inhaled 8% Sevoflurane with mask, Patients in Sevoflurane-Remifentanil groups（SR） were inhaled Sevoflurane until eyelash reflection disap- peared , then injected intravenously remifentanyl 2 μg/kg within 45s. Used Viby-Mogensen score to assess the intubation conditio. Results Compared with SR group, the incidence cough reflex, the satisfactory rate of body reaction and success rate of first tracheal intubation in the DS group was enhanced. During intubation, four patients had hypotension and two patients had bradyarrhythmia in SR group, but there was no patient in DS group. Conclusion Compared with remifentanyl,using Dexmedetomidine, 1μg/kg, combined with Sevoflurane for induction offer better condition of intubation, fewer side effect and situation of maintaining spontaneous breath for intubation.

关 键 词：吸入麻醉 右美托咪啶 气管内插管 气管狭窄 

分 类 号：R971.9[医药卫生—药品]